AIM: To investigate the genetic association and potential causal relationship between diabetic nephropathy(DN)and diabetic retinopathy(DR), and to elucidate their shared molecular mechanisms through differential gene expression analysis and Mendelian randomization(MR).METHODS: Transcriptomic data of DN and DR were obtained from the Gene Expression Omnibus(GEO)database and analyzed for differentially expressed genes(DEGs). Genes meeting the significance threshold(log2FC>1, P<0.05)were identified, followed by Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis to explore shared biological pathways. Using genome-wide association study(GWAS)summary statistics for DN and DR, two-sample MR analysis was performed, with DN as the exposure and DR as the outcome. The causal effect was primarily estimated with the inverse-variance weighted(IVW)method, and sensitivity analyses were conducted to assess robustness.RESULTS: MR analysis revealed that DN significantly increased the risk of DR. IVW estimates indicated that the odds ratio(OR)for non-proliferative DR(NPDR)was 3.23(95% CI: 2.12-4.95, P<0.001), and the OR for proliferative DR(PDR)was 1.10(95% CI: 1.06-1.15, P<0.001). DEG analysis identified several key genes, including FN1, COL1A2, and THBS2. FN1 and COL1A2 are involved in extracellular matrix remodeling and fibrosis, contributing to vascular permeability alterations and microvascular damage in diabetic complications. THBS2 is closely associated with angiogenesis and vascular homeostasis, suggesting its potential role in DR. KEGG enrichment analysis showed that these DEGs were mainly enriched in advanced glycation end products(AGEs)-RAGE signaling, extracellular matrix degradation, and oxidative stress pathways, all of which are highly relevant to the pathogenesis of DN and DR.CONCLUSION: This study demonstrates the genetic association between DN and DR using MR and DEGs analyses. The shared mechanisms, particularly involving extracellular matrix remodeling, inflammatory response, and angiogenesis, may serve as novel therapeutic targets and provide a theoretical basis for the early diagnosis and targeted treatment of diabetic complications.

The adjacent anatomy of the pelvis is complicated, with digestive, urinary, reproductive and other organs as well as important blood vessels and nerves. Therefore, accurate resection of pelvic tumors and precise reconstruction of defects after resection are extremely difficult. The development of medical 3D printing technology provides new ideas for precise resection and personalized reconstruction of pelvic tumors. The “triune” application of 3D printing personalized lesion model, osteotomy guide plate and reconstruction prosthesis in pelvic tumor limb salvage reconstruction treatment has achieved good clinical results. However, the current lack of normative guidance standards such as preparation and application of 3D printing personalized lesion model, osteotomy guide plate and reconstruction prosthesis restricts its promotion and application. The formulation of this consensus provides normative guidance for 3D printing personalized pelvic tumor limb salvage reconstruction treatment.

Objective To investigate the efficacy of micro?surgery for the treatment of medulla oblongata cavernomas. Methods A retrospective analysis was conducted on the clinical data of 21 patients with cavernous hemangioma who received micro?surgical treatment. Of the 21 patients, 13 were men and 8 women,aged 22 to 63 years. The preoperative Karnofsky performance status(KPS)score was 76.5 ± 10.2. The main clinical manifestations included sensory disorder and difficulty swallowing etc. According to the location of the lesions ,the posterior transchoroidal fissure approach was employed for 16 patients;far?lateral approach,5 patients. Electrophysiological monitoring and nervous system navigation were supple?mentarily adopted in both types of surgery. Further ,KPS scoring was conducted to evaluate the patients 'quality of life. Results The medulla cav?ernous hemangioma was excised in all cases. For 17 patients with primary neurological disorders ,their symptoms were alleviated or resolved;4 pa?tients had severe symptoms and 8 presented with new clinical symptoms. A follow?up visit was conducted 8 to 97 months post?surgery(average 47.6 months). All patients were found capable of caring for themselves in daily life and performing simple or normal learning and working activities without recurrence or bleeding. The mean postoperative KPS score was 83.7 ± 15.5. Conclusion Patients with medulla cavernous hemangioma bleeding or severe symptoms should actively seek surgical treatment. Repeated bleeding is the absolute indication for surgery. Surgical skills ,elec?trophysiological monitoring,and nervous system navigation can reduce nervous system damage and protect the brainstem. The patient's quality of life is expected to significantly improve after surgery.

Objective To explore the therapeutic effect of Jinkoubao on oral ulcer in rabbits and its action mechanism.Methods Among 60 SPF NewZealand rabbits,6 cases were randomly selected for the ulcer model identification,and the rest was randomly and equally divided into 3 groups:the control group (NC group),normal saline drug film group (NS group) and Jinkoubao film group (JK group).The rabbit model of oral ulcer was constructed by applying 40 ％ glacial acetic acid to burn rabbit oral mucosa for duplicating the oral ulcer model.of the change situation of oral ulcer was observed on the same day for constructing model,on 3,5,7 d after medication.The EGF level in oral mucosal tissue was detected by using RT-PCR and the local histopatho1ogical changes in oral ulcer was observed by using HE staining method.Results Compared with the NS group,the ulcer area on 3,5,7 d after medication in the JK group was significantly deceased (P＜0.01).Compared with the NS group,the EGF level in oral buccal mucosal tissue in the NS group and JK group was markedly increased (P＜0.01).But the EGF level increase in the JK group was faster than that in the NS group,the difference was statistically significant(P＜0.01).The HE staining section of rabbit oral ulcer on 3,5,7 d after medication showed that the inflammatory cells decrease in the JK group was more obvious than that in the NS group,fibroblasts proliferation was obvious and epithelial hyperplasia was good.Conclusion Jinkoubao could greatly improve the symptoms of oral ulcer in rabbits and promotes its healing,which is possible to strengthen the repair capacity of oral ulcer by regulating the EGF level.

To meet the requirements of social development, this article explored the significance of establishing the course of nursing financial management and described the current development situation of establishing the course of nursing financial management. This article also put forward some thinking and suggestions for establishing the course of nursing financial management involving promoting nursing financial research, perfecting the compilation of teaching material, strengthening the construction of teaching staff to improve the teaching level, carrying out diversified teaching form to meet different demands and evaluating teaching comprehensively to improve the quality of teaching.

Objective To compare the myocardial protection effects of cold blood cardioplegia and cold crystalloid cardioplegia in patients undergoing valve replacement surgery.Methods One hundred adult patients with cardiac function Ⅱ～Ⅲ class undergoing primary elective valve replacement surgery due to rheumatic heart disease were retrospectively analyzed.For patients with cardiac arrest,cold blood cardioplegia was applied to 50 cases(Group B),and cold crystalloid cardioplegia to the others(group C).The process of heart resuscitation,the postoperative need of dopamine,the blood pressure and heart rate,the postoperative level of serum myocardial enzyme,the intensive care unit(ICU) stay after operation were collected and statistically analyzed.All the cardioplegic solution was perfused in a similar manner and topical cooling was employed simultaneously.Results There were less cases in group B than in group C who needed isoprenaline for cardiac resuscitation after clamp removal(P0.05).Conclusion The cold blood cardioplegia and cold crystalloid cardioplegia have similar myocardial protection effects on rheumatic heart disease patients with cardiac function Ⅱ～Ⅲ class undergoing valve replacement surgery.